Boca Raton Regional Hospital is the first in Palm Beach County to offer
the Zimmer® Patient Specific Instruments (PSI) Shoulder System for
individuals in need of a reverse shoulder replacement. The System utilizes
advanced, 3D visualization software to create surgical plans that are
customized to each patient’s unique anatomy and patient-specific
instrument guides that enhance the accuracy in placement of the shoulder implant.

Every year, thousands of conventional total shoulder replacements are
successfully performed in the United States for patients with shoulder
arthritis. This type of surgery, however, is not as beneficial for patients
with large rotator cuff tears who have developed a complex type of shoulder
arthritis called “cuff tear arthropathy.” For these patients,
conventional total shoulder replacement may result in pain and limited
motion, and reverse total shoulder replacement may be an option.

A conventional shoulder replacement device mimics the normal anatomy of
the shoulder: a plastic “cup” is fitted into the shoulder
socket (glenoid), and a metal “ball” is attached to the top
of the upper arm bone (humerus). In a reverse total shoulder replacement,
the socket and metal ball are switched. The metal ball is fixed to the
socket and the plastic cup is fixed to the upper end of the humerus.

“This is a tremendous advance in our approach to reverse shoulder
replacement procedures,” said Charles Toman, MD, orthopedic surgeon
at Boca Raton Regional Hospital. “The PSI System allows us to place
the implant with the utmost precision, which in turn lessens postoperative
pain and fosters a faster recovery.”

Data published in the
Journal of Bone and Joint Surgery showed that the use of PSI has been shown to support optimal implant selection
and placement for shoulder replacement procedures, which can result in
improved surgical results. “To date, our results at Boca Regional
with PSI have been stellar, from both the surgical perspective and in
patient satisfaction,” commented Dr. Toman.

The PSI process begins with preoperative CT imaging of the patient’s
shoulder anatomy. These images are then relayed to biomechanical engineers
who use specialized computer software to develop a customized surgical
plan that includes implant size and placement, bone preparation and the
positioning of surgical screws. Patient-specific surgical instrument guides
then facilitate the placement of the implant corresponding to the personalized
surgical plan.

According to Dr. Toman, PSI enhances the surgeon’s ability to accurately
position the glenoid component of the implant, which is the most common
challenge in shoulder replacement surgery and the main source of postoperative
complications.

“PSI is designed to minimize bone removal while maximizing implant
fixation in reverse shoulder replacement,” said Dr. Toman. “And
those are two very good things to occur if you are undergoing the procedure.”

Boca Raton Regional Hospital is an advanced, tertiary medical center
(BRRH.com) with 400 beds and more than 800 primary and specialty physicians on staff.
The Hospital is a recognized leader in oncology, cardiovascular disease
and surgery, minimally invasive surgery, orthopedics, women’s health,
emergency medicine and the neurosciences, all of which offer state-of-the-art
diagnostic and imaging capabilities. The Hospital is a designated Comprehensive
Stroke Center by the Florida Agency for Health Care Administration (AHCA).

Boca Raton Regional Hospital is the recipient of the 2014 Distinguished
Hospital Award for Clinical Excellence™ for the 10th year in a row
and was named one of America’s 50 Best Hospitals in 2011, 2012,
2013 and 2014 both by Healthgrades®. Boca Raton Regional Hospital
was also recognized for the third consecutive year in
U.S. News & World Report’s 2013–2014 Best Hospitals listing as a top-ranked hospital in the
South Florida metropolitan area.